This issue of BIC Update focuses on the differences between chiropractic doctors and medical doctors. Many people think doctors of chiropractic are somehow less well trained and less qualified than medical doctors. The public often does not understand how rigorous the chiropractor's course of study is.

Chiropractors Get Plenty of Science Training

In fact, doctors of chiropractic are highly qualified specialists who have at least six years of college training (two years of pre-professional training, plus four years of professional training in chiropractic college). The chiropractic curriculum gives the chiropractor the same basic knowledge required to become a general practitioner. In addition, chiropractors often take additional post-doctoral trainings and certifications to enhance their ability to treat nutritional deficiencies and the entire body structure.

As the following chart shows, a chiropractic student spends approximately the same amount of time studying basic and clinical sciences as a medical student does.

Number of Hours Spent Studying 

The basic science courses include: human anatomy, microscopic anatomy, neuroanatomy, neuroscience, physiology, pathology, biochemistry, microbiology and infectious diseases, lab diagnosis, clinical nutrition, immunology, toxicology and community health.

You will notice that all the medical student's clinical science hours are spent in clerkship, that is, clinical experience or supervised management of patients. For the chiropractic student clinical science is divided between chiropractic science and clerkship. Chiropractic science includes learning diagnostic and treatment methods (such as biomechanical diagnosis of the musculoskeletal system, manipulation and other manual treatment methods, and use of skeletal diagnostic x-rays and other imaging methods). The reason for this difference is that chiropractic students are being prepared for a specialized patient contact or primary care role and they do not need the same depth of experience with disease states as medical doctors do.

The main difference between doctors of chiropractic and medical doctors is their approach to treatment. The chiro-practor's focus is on physiological and biochemical aspects of healing, including structural, spinal, musculoskeletal, neurological, vascular, nutritional, emotional and environmental relationships. The medical doctor focuses on disease states and the use of pharmaceuticals or invasive surgery to treat those states.

Post-Doctoral Training Enhances the Chiropractor's Skills

Certified Chiropractic Extremity Practitioner

As mentioned above, some chiropractors take additional training in order to better serve their patients. For example, a certified chiropractic extremity practitioner (CCEP) has specialized training to correct problems with the extremities (TMJ, ribs, shoulder, elbow, wrist, fingers, hip, knee, ankle, foot and toes). I completed this six-month 84.5-hour post-doctoral course in 1998 to become one of four CCEP doctors in the Houston area.

Extremity adjustment or manipulation is used to correct joint fixations anywhere in the body other than the spine. When any joint does not move properly, it stretches the attached ligaments, triggering sensory receptors to signal the brain. The result is pain in the affected joint. The brain sends a signal back to the adjacent muscles, reducing their strength in order to protect them from injury.

Manipulation of the fixed extremity by a properly trained chiropractor restores the stretched ligament to its normal length. The brain then allows full strength to return to the adjacent muscles. Pain also decreases immediately.

Sometimes lax or overstretched ligaments and tendons make a joint unstable and let it move too much. In this case, adjusting the joint alone is not enough to correct the problem. Strengthening exercises and perhaps taping must be used to permit the ligament to tighten and restore stability to the joint.

Extremity manipulation provides excellent results for many patients and often helps them avoid having surgery.

Functional Medicine

Functional medicine focuses on detecting, identifying and correcting nutritional deficiencies before they result in pathological conditions. Chiropractic training includes clinical nutrition among the basic science courses.

After graduating from chiropractic college, I sought additional training in the use of nutritional diagnostic tools and treatments from Innovative Practice Solutions (IPS), a leading patient education organization. I completed the basic IPS 52-hour program in 1997 and have attended additional IPS programs totaling over 120 hours.

I've also attended two 12-hour programs on functional medicine approaches to anti-aging, physical and nutritional medicine and on managing chronic illness. These programs were presented by nutrition researcher Jeff Bland, Ph.D., the founder and CEO of HealthComm International, Inc., a leading research and development company in the field of functional medicine.

Functional medicine assesses early indicators of potential problems and used these indicators as a basis for treatment, rather than waiting until a clinical problem develops. Traditional medical often misses these indicators. Yet through functional medicine the condition can be identified and addressed before it becomes a problem. I have found functional medicine protocols and patient education materials to be very helpful to my patients.

What Chiropractic Training Means for You

Many of our clients, whether they come to us for chiropractic care or massage therapy, do not realize the full range of services we offer. As a CCEP and functional medicine specialist, I can address problems involving much more than the patient's spine. I also help patients with a variety of other problems, such as the following:

Patients who have chronic foot pain often have a structural imbalance in the feet. They may benefit from using orthotics. I can prescribe and fit custom orthotics, then make them for you, all in the same visit.

Another common complaint is knee pain. Patients often think they have arthritis if they experience an occasional or constant dull ache in their knees. Osteoarthritis develops over a long period of time from out-of-balance joint articulation or movement. Knee pain may indicate that you have some degree of arthritis, but in many cases you only need manipulation to put your knees back into proper alignment and stretching and strengthening exercises to correct the muscle imbalances.

Many patients complain of acid reflux or indigestion. Instead of treating the symptom with antacids, the functional medicine approach seeks to correct the imbalance in acid production to restore normal digestion. I work with patients to achieve this goal. I find that if you support your body and give it what it needs to stabilize, your body will often heal itself and you will no longer need to take medication.